U.S. patent application number 13/215703 was filed with the patent office on 2012-03-01 for smart mattress.
This patent application is currently assigned to EVACUSLED INC.. Invention is credited to Miriam Gordon, Hart Victor Katz, Christopher Kenalty.
Application Number | 20120053424 13/215703 |
Document ID | / |
Family ID | 45698122 |
Filed Date | 2012-03-01 |
United States Patent
Application |
20120053424 |
Kind Code |
A1 |
Kenalty; Christopher ; et
al. |
March 1, 2012 |
SMART MATTRESS
Abstract
A mattress has a sensor pad affixed on a top surface thereof.
The sensor pad has (i) a matrix array of plural pressure sensors,
(ii) plural row conductors, and (iii) plural column conductors.
Each intersecting row and column conductor provides an electrical
signal from a corresponding sensor when pressure is applied
thereto. The sensor pad has plural through-holes therein disposed
between the plural row conductors the plural column conductors,
respectively. Preferably, at least one patient-mounted
physiological sensor is configured to provide an output signal
corresponding to a patient physiological parameter. An electronic
unit is mounted inside the mattress and is configured to receive
signals from the sensor pad. The electronic unit has a data storage
unit preferably storing (i) patient identification information,
(ii) patient physiological information, and (iii) mattress
information. A wireless transmitter is coupled to the electronic
unit and is configured to wirelessly communicate at least the
stored patient physiological information to an off-mattress
device.
Inventors: |
Kenalty; Christopher;
(Toronto, CA) ; Gordon; Miriam; (Mississauga,
CA) ; Katz; Hart Victor; (Toronto, CA) |
Assignee: |
EVACUSLED INC.
Toronto
CA
|
Family ID: |
45698122 |
Appl. No.: |
13/215703 |
Filed: |
August 23, 2011 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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12862253 |
Aug 24, 2010 |
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13215703 |
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Current U.S.
Class: |
600/300 |
Current CPC
Class: |
A61B 2505/00 20130101;
G01L 19/0092 20130101; A47C 27/002 20130101; A61B 5/0015 20130101;
A47D 15/001 20130101; G01L 15/00 20130101; A61B 5/6892 20130101;
A61B 5/0205 20130101; A61B 2560/0468 20130101; A61B 2562/046
20130101; G01L 2019/0053 20130101; A61B 6/0407 20130101; A61B
2562/0247 20130101; A61B 5/0002 20130101 |
Class at
Publication: |
600/300 |
International
Class: |
A61B 5/00 20060101
A61B005/00 |
Claims
1. A mattress comprising: a sensor pad affixed on a top surface of
the mattress, said sensor pad having (i) a matrix array of plural
pressure sensors, (ii) plural row conductors, and (iii) plural
column conductors, each intersecting row and column conductor being
configured to provide an electrical signal from a corresponding
sensor when pressure is applied thereto, said sensor pad having
plural through-holes therein disposed between said plural row
conductors said plural column conductors, respectively; at least
one connector coupled to outputs of the row and column conductors;
at least one patient-mounted physiological sensor configured to
provide an output signal corresponding to a patient physiological
parameter; an electronic unit mounted inside said mattress and
having a panel mounted on a side of said mattress, said panel
configured to receive signals from said at least one connector,
said electronic unit having a data storage unit storing (i) patient
identification information, (ii) patient physiological information,
and (iii) mattress information, said electronic unit receiving
signals from said at least one patient-mounted physiological
sensor, said electronic unit having a processor; and a wireless
transmitter coupled to said electronic unit and configured to
wirelessly communicate at least the stored patient physiological
information to an off-mattress device.
2. A mattress according to claim 1, wherein said sensor pad
comprises a laminate having a sensor substrate sandwiched between a
row conductor substrate and a column conductor substrate.
3. A mattress according to claim 1, wherein the sensor pad is
disposed inside an envelope affixed to the top surface of the
mattress.
4. A mattress according to claim 1, wherein the electronic unit
includes a portable electrical energy source.
5. A mattress according to claim 1, wherein the wireless
transmitter is configured to transmit via at least one of Bluetooth
and WiFi.
6. A mattress according to claim 1, wherein said electronic unit
includes a GPS device.
7. A mattress according to claim 1, wherein said electronic unit
scans said plural row conductors and said plural column conductors,
and provides a signal corresponding to a pressure map of the
patient's body.
8. A mattress according to claim 1, further comprising a portable
unit in communication with said wireless transmitter.
9. A mattress according to claim 1, further comprising a call
button coupled to said electronic unit panel.
10. A mattress according to claim 1, wherein the sensor pad is
configured to detect at least one of temperature and liquid.
11. A mattress according to claim 1, wherein said electronic unit
is configured to detect respiration based on outputs of said sensor
pad.
12. A mattress according to claim 1, wherein said electronic unit
is configured to detect heart beat based on outputs of said sensor
pad.
13. A mattress according to claim 1, wherein said electronic unit
is configured to provide an alarm signal whenever a monitored
physiological parameter exceeds a predetermined threshold.
14. A Sudden Infant Death Syndrome-detecting mattress, comprising:
a sensor pad affixed on a top surface of the mattress, said sensor
pad having (i) a matrix array of plural pressure sensors, (ii)
plural row conductors, and (iii) plural column conductors, each
intersecting row and column conductor being configured to provide
an electrical signal from a corresponding sensor when pressure is
applied thereto, said sensor pad having plural through-holes
therein disposed between said plural row conductors said plural
column conductors, respectively; and an electronic unit mounted
inside said mattress is configured to receive signals from said row
and column conductors, said electronic unit having a processor for
receiving the received signals and providing an alarm signal when
an infant on said mattress has stopped breathing for a
predetermined period of time.
15. A mattress according to claim 14, wherein said alarm signal
comprises an audible alarm.
16. A mattress according to claim 14, further comprising a wireless
transmitter coupled to said electronic unit and configured to
wirelessly communicate the alarm signal to an off-mattress
device.
17. A mattress according to claim 16, further comprising a portable
unit in communication with said wireless transmitter.
18. A mattress according to claim 16, wherein the wireless
transmitter is configured to transmit via at least one of Bluetooth
and WiFi.
19. A mattress according to claim 14, further comprising a triage
tag affixed to the mattress.
20. A method of sensing physiological information of a patient
lying on a mattress, comprising: providing a sensor pad affixed on
a top surface of the mattress, said sensor pad having (i) a matrix
array of plural pressure sensors, (ii) plural row conductors, and
(iii) plural column conductors, said sensor pad having plural
through-holes therein disposed between said plural row conductors
said plural column conductors, respectively; each intersecting row
and column conductor providing an electrical signal from a
corresponding sensor when pressure is applied thereto; providing an
electronic unit inside said mattress, said electronic unit having a
data storage unit storing (i) patient identification information,
(ii) patient physiological information, and (iii) mattress
information; said electronic unit receiving signals from said
sensor pad, said electronic unit having a processor; and providing
a wireless transmitter coupled to said electronic unit; and
wirelessly communicate at least the stored patient physiological
information to an off-mattress device.
Description
[0001] Reference is hereby made to the computer program listing
appendix submitted herewith. The material in the appendix is hereby
incorporation-by-reference in the specification. One appendix is
submitted herewith and includes files: Acquisition Thread;
PadGenerator; Patient; Program; SMatrix; AvgGraph Designer;
AvgGraph; BasePane Designer; BasePane; BodyMap Designer; BodyMap;
LogCntrl Designer; LogCntrl; Pane Caption Designer; PaneCaption;
Patient Ctrl Designer; PatientCtrl; DesignGridForm Designer;
DesignGridForm; FormMain Designer; FormMain; PatientForm Designer;
PatientForm; FileList; AssemblyInfo; Resources.Designer; and
Settings.Designer
TECHNICAL FIELD
[0002] The present invention relates to a Smart Mattress for the
real-time medical monitoring of individuals such as hospital
patients, bed-ridden patients, and infants susceptible to Sudden
Infant Death Syndrome (SIDS). More particularly, the invention
relates to such a mattress which is capable of measuring and
reporting (locally or remotely) a patient's vitals and other
information to a server and/or caregiver during emergency and
non-emergency situations.
BACKGROUND INFORMATION
[0003] There are a number of existing methods and apparatuses which
are capable of providing for real-time monitoring of a patient's
vital statistics ("vitals"). These apparatuses include
electrocardiogram recorders, heart rate monitors, blood pressure
monitors, electroencephalograph apparatus, pulse monitors,
oximeters, carbon dioxide meters, thermostats, scales, maternal
uterine activity monitors, and various other non-invasive medical
instruments.
[0004] A major concern with current noninvasive medical instruments
is that they are often bulky and require an excessive number of
cables in order to report the measurements to a computer or
physician. Everyone is familiar with the image of a hospital
patient excessively wired to many machines surrounding or attached
to the patient's bed. Access to such patients is difficult during
normal treatment, but becomes a real problem in emergency
situations where rapid evacuation may be required. In emergencies,
non-ambulatory or bed-ridden patients must be quickly and safely
evacuated from hospitals, a situation in which patients wait (often
for hours in a parking lot) for transportation to another hospital.
In such emergencies, because of the issues mentioned above, most
current medical instrumentation cannot be quickly and effectively
packed up to preserve substantially uninterrupted patient
monitoring. Similarly, in the case of home health care, it would be
highly desirable to simplify and/or create more user-friendly
monitoring methods by reducing the amount of equipment and creating
a self-contained, maintenance-free monitoring device.
[0005] Numerous improvements in the medical field have been made to
reduce the number of monitors physically attached to a patient, and
the size and number of devices in a hospital room, by integrating
certain sensor devices into the existing bedding of a patient. The
following patents and patent publications, which are hereby
incorporated by reference in their entirety herein, disclose a
number of contactless, non-invasive patient monitoring methods.
[0006] A mattress pad disclosed in U.S. Patent Publication No.
20070149883 to Yesha has at least two pressure-sensitive
piezoelectric sensors positioned in a rigid pad beneath the
patient's mattress. The mattress pad includes a processor to
receive successive sensor measurements and calculate heart and
respiration rates, which are determined by subtracting the pressure
signals corresponding to the upper body and the lower body of a
patient and mathematically determining the maximum difference of
signals between each group of sensors. The heart and respiration
rates are then transmitted by a cable to existing patient
monitoring equipment. This system, however, requires that a rigid
pad be properly disposed and positioned beneath the mattress while
physically connected to an auxiliary device, restricting both the
mobility and versatility of the monitoring system.
[0007] A mattress with integrated piezoelectric sensors disclosed
in U.S. Pat. No. 7,652,581 to Gentry has a passive sensor, or
sensor array, in the mattress pad that supports continuous
monitoring of a patient's physiological condition in a hospital
setting. The external processor receives sensor data, either by
wired or wireless communication, from mattress pad sensors, and
processes the sensed data into a form that is usable by a
physician, nurse or other user. As in Yesha, this is not a
self-contained monitoring mattress and still requires auxiliary
equipment to receive and process sensor data.
[0008] Yet another monitoring mattress pad apparatus is disclosed
in U.S. Pat. No. 7,164,941 to Misczynski. This document discloses a
contactless electromagnetic inductance device which collects
cardiac activity signals to evaluate patient sleep. As in Yesha,
the system is not self-contained and also does not permit storage
of patient data.
[0009] There are numerous other patents and published patent
applications which employ a pad or embedded mattress sensor coupled
to an auxiliary device. One apparent disadvantage is the lack of a
self-contained system and the reliance on or requirement of an
auxiliary device. Another disadvantage is the lack of embedded
storage for patient identification and other data, such as a
patient's chart information.
[0010] Thus, what is needed is a self-contained Smart Mattress
which is capable of monitoring vital statistics of a patient in
real time, analyzing data using an embedded processor, storing
patient identification and medical information, producing an
electronic medical report, and communicating pertinent data to a
caregiver or computer server using wireless technology, such as
Bluetooth.RTM. Technology. Due to the self-contained, portable
nature of the Smart Mattress and Smart Mattress technology, it is
also ideal for use with an emergency evacuation mattress system for
hospital patients and other bed-ridden patients.
SUMMARY
[0011] Health care providers are very mobile, and the adoption of
enhanced wireless technology by health care organizations,
especially when harnessed properly, can help to improve, even
automate, patient care and monitoring, save costs, and reduce staff
injuries. It is indisputable that computer networks are commonplace
in health care organizations and in some places are indispensable.
However, most of the computer devices and monitoring devices are
connected through the use of wires; this usually means that their
use is limited to a fixed place. A Smart Mattress eliminates many
of the wires associated with current methods and allows for greater
flexibility in patient monitoring.
[0012] According to a first aspect of the present invention, a
mattress has a non-rigid, flexible sensor pad affixed on a top
surface thereof. The sensor pad has (i) a matrix array of plural
pressure sensors, (ii) plural row conductors, and (iii) plural
column conductors. Each intersecting row and column conductor
provides an electrical signal from a corresponding sensor when
pressure is applied thereto. The sensor pad having plural
through-holes therein disposed between the plural row conductors
the plural column conductors. A connector is preferably coupled to
outputs of the row and column conductors. Preferably, at least one
patient-mounted physiological sensor is configured to provide an
output signal corresponding to a patient physiological parameter.
An electronic unit is mounted inside the mattress and preferably
has a panel mounted on a side of the mattress. The panel is
configured to receive signals from the connector. The electronic
unit has a data storage unit preferably storing (i) patient
identification information, (ii) patient physiological information,
and (iii) mattress/bed information. The electronic unit receives
signals from at least one patient-mounted physiological sensor. A
wireless transmitter is coupled to the electronic unit and is
configured to wirelessly communicate at least the stored patient
physiological information to an off-mattress device.
[0013] According to a second aspect of the present invention, a
Sudden Infant Death Syndrome-detecting mattress includes a sensor
pad affixed on a top surface of the mattress. The sensor pad having
(i) a matrix array of plural pressure sensors, (ii) plural row
conductors, and (iii) plural column conductors. Each intersecting
row and column conductor is configured to provide an electrical
signal from a corresponding sensor when pressure is applied
thereto. The sensor pad has plural through-holes therein disposed
between the plural row conductors the plural column conductors. An
electronic unit is mounted inside the mattress and is configured to
receive signals from the row and column conductors. The electronic
unit has a processor for receiving the received signals and
providing al alarm signal when an infant on the mattress has
stopped breathing for a predetermined period of time.
[0014] According to a third aspect of the present invention, a
method of sensing physiological information of a patient lying on a
mattress, includes providing a sensor pad affixed on a top surface
of the mattress, the sensor pad having (i) a matrix array of plural
pressure sensors, (ii) plural row conductors, and (iii) plural
column conductors. The sensor pad has plural through-holes therein
disposed between the plural row conductors the plural column
conductors, respectively. Each intersecting row and column
conductor providing an electrical signal from a corresponding
sensor when pressure is applied thereto. An electronic unit is
provided inside the mattress, and has a data storage unit storing
(i) patient identification information, (ii) patient physiological
information, and (iii) mattress/bed information. The electronic
unit receives signals from the sensor pad, and has a processor. A
wireless transmitter is coupled to the electronic unit, and
wirelessly communicates at least the stored patient physiological
information to an off-mattress device.
BRIEF DESCRIPTION OF THE DRAWINGS
[0015] FIG. 1 is a high-level diagram illustrating a first
embodiment for using Smart Mattress;
[0016] FIG. 2 is a diagram illustrating a first embodiment for
using Smart Mattress;
[0017] FIG. 3 is a diagram illustrating a second embodiment for
using Smart Mattress;
[0018] FIG. 4 is an exemplary screen shot of the portable
device;
[0019] FIG. 5 is a diagram illustrating a portable device;
[0020] FIG. 6 is a diagram illustrating an exterior embodiment of a
Smart Mattress;
[0021] FIG. 7 is a schematic diagram of the breakout unit
preferably embedded in the mattress;
[0022] FIG. 8 shows an example of a patient display presented on
the display of a mobile unit;
[0023] FIG. 9 is a schematic perspective view showing a preferred
embodiment of the Smart Mattress with the sensor pad(s) installed
in an envelope enclosure affixed to the top surface of a
mattress;
[0024] FIG. 10 is a schematic of the sensor pad wiring
arrangement;
[0025] FIG. 11 is a partial schematic showing some of the pad
sensors, some of the pad conductors, and how they are coupled to
the connector;
[0026] FIGS. 12a, 12b, and 12c are notional schematic drawings
showing the assembly of the sensor pad; and
[0027] FIG. 13 is a notional cross-sectional view of the pad
showing the sensing elements, the column (or row) conductors, and
the row (or column) conductors.
DETAILED DESCRIPTION OF THE PRESENTLY PREFERRED EXEMPLARY
EMBODIMENTS
[0028] A preferred embodiment of the present invention will be
described herein below with reference to the accompanying drawings.
In the following description, well-known functions or constructions
are not described in detail since they would obscure the invention
in unnecessary detail.
[0029] For this application the following terms and definitions
shall apply:
[0030] The terms "communicate" and "communicating" as used herein
include both conveying data from a source to a destination and
delivering data to a communications medium, system, channel,
network, device, wire, cable, fiber, circuit and/or link to be
conveyed to a destination, and the term "communication" as used
herein means data so conveyed or delivered. The term
"communications" as used herein includes one or more of a
communications medium, system, channel, network, device, wire,
cable, fiber, circuit and link.
[0031] The term "processor" as used herein means non-transitory
processing devices, apparatus, circuits, components, systems and
subsystems, whether implemented in hardware, or a combination of
hardware and software, and whether or not programmable. The term
"processor" as used herein includes, but is not limited to, one or
more computers, hardwired circuits, signal modifying devices and
systems, devices and machines for controlling systems, central
processing units, programmable devices and systems,
field-programmable gate arrays, application-specific integrated
circuits, systems on a chip, systems comprising discrete elements
and/or circuits, state machines, virtual machines, data processors,
processing facilities and combinations of any of the foregoing.
[0032] The present disclosure endeavors to provide a Smart Mattress
and/or Smart Mattress system capable of monitoring the vital
statistics of a patient in real time, analyzing the data using an
embedded processor, storing patient identification and information
and mattress and/or bed information (where the bed comprises a
mattress and the frame), producing an electronic medical report,
and communicating any data to a care provider, computer server, or
portable device using wireless technology. A portable device may be
a cell phone, smart phone, Personal Digital Assistant ("PDA"),
media player/reader, computer laptop, tablet PC, or any other
processor-based device that is known in the art, including a
desktop PC and/or computer workstation. Using a portable device
allows for more flexibility when monitoring a patient or during
emergency evacuations by allowing the health care provider to
monitor from a distance or to receive automatic alerts when a
patient's condition changes.
[0033] Integrating a Smart Mattress with a hand-held device in an
emergency evacuation system has not been done, to the knowledge of
the inventors. Use of a Smart Mattress alone or in combination with
a portable device will enhance data collection during both
day-to-day monitoring at home or in a health care facility, or
while in emergency evacuations. Use of a Smart Mattress improves
data accuracy, reduces paperwork, supports collection of more
complete information, updates critical information faster,
eliminates redundant data entry, allows faster adaptation to
changing conditions and provides access to previously unavailable
information. Additionally, when a patient is transferred to an
alternate facility, patient records, which may be stored in a Smart
Mattress data storage unit ("DSU"), travel with the patient.
1. Structure
[0034] Referring now to FIG. 1, a Smart Mattress 102 system is
depicted. The Smart Mattress 102 system of FIG. 1 uses a
communication network 104 to wirelessly transmit a patient's
physiologic data, and/or dynamic patient data, and/or patient
demographic data, and/or mattress data from a breakout unit 700 in
the mattress 102 to portable device 106, monitoring station 110,
and/or other computer server 112. The portable device 106 may be
carried by a health care provider 108 or other personnel interested
in the health of a patient. A monitoring station 110 may be either
a local in-hospital nurses' station or a remote monitoring station.
Alternatively, patient data may be communicated to a computer
server 112 which may be capable of automatically monitoring a
patient's health state or forwarding dynamic patient data to one or
more health care personnel, for example, if a patient's health
condition deviates from a predetermined value. Preferably, all data
communication to/from the Smart Mattress is encoded (to comply with
HIPPA requirements) and compressed; and all servers, communication
devices, and memory devices are HIPPA-compliant. The breakout unit
700 is preferably embedded in the mattress with a connector panel
on an outer surface thereof (See FIGS. 6 and 7). The breakout unit
700 is preferably mounted inside the mattress in a rigid or
semi-rigid enclosure having one or more rack/slide/drawer
structures, to make replacement and/or repair of the breakout unit
700 simple. Also, it is preferred that the breakout unit enclosure
be waterproof and/or RFI-shielded.
[0035] In FIG. 7, the breakout unit 700 preferably includes a data
storage unit ("DSU") 222 for storing patient information (e.g.,
demographics such as name, height, weight, gender, date of birth,
race, religion and blood type), for storing and automatically
updating a patient's physiological data (e.g., body temperature,
systolic and diastolic blood pressures, pulse, respiratory, pulse
oximetry and electrocardiogram), for storing mattress and/or bed
information; and a processor for handling, processing and/or
time-stamping any updates to the DSU. The DSU 222 may be removable
and/or may include permanent memory together with a removable
memory such as a flash drive, EEPROM, SD card, etc. In a preferred
embodiment, the breakout unit 700 also includes an on-board power
source 704, such as one or more rechargeable batteries, to increase
the portability of a Smart Mattress and/or provide power backup in
case of emergencies. Preferably, the Smart Mattress is also capable
of receiving operating and/or recharging power directly from an
auxiliary power source (e.g., wall socket, solar panel, and/or
generator) via cable 706. The breakout unit 700 may also include a
call button 708 which signals to the caregiver 108 that assistance
is needed (e.g. via the portable device 106, monitoring station
110, and/or audible alarm). The breakout unit 700 may also include
a GPS transmitter and/or receiver 730 to provide accurate location
information for emergency or routine transportation.
[0036] The breakout unit 700 also preferably includes an on/off
switch 709, and a PCB-based junction box 710 which will accept the
high density of incoming wires from the sensor arrays (to be
described below). Amplifier circuitry 712 is also provided to
amplify the incoming sensor signals. An Analog/Digital conversion
unit 714 performs typical A/D functions and preferably converts the
sensor array signals at least once every minute (although the
frequency of scanning and, thus, conversion may vary depending on
the condition being monitored). Each sensor in the array may be
sampled once every 10 seconds--i.e., at a rate of 0.1 Hz per
channel. This implies an input data rate to the multiplexer of
about 250 Bytes per sensor per second, or 1 KByte per second for
all signals. Conversion of all channels may occur in approximately
1 second. Multiplexor circuitry 716 is also provided and will
accept a 1 KHz data stream from all of the sensors of the array.
Wireless transmission circuitry (e.g., Bluetooth and/or WiFi) 216
transmits to/from a local or remote processor.
[0037] While FIG. 7 depicts various connections between these
units, this is schematic only and not limiting. The connections may
be made by way of bus 720, or any other connection structure
typical of such circuitry. The breakout unit 700 is coupled to the
mattress sensor array, matrix, grid 722 (to be discussed below),
and to a mattress display unit (MDU) 724 which may be co-located
with the mattress or in the mattress itself as a stand-alone unit
or as part of the breakout unit. The MDU 724 features the
following, for each array sensor type (e.g., pressure, temperature,
liquid, and/or acoustic): (i) Generation of a color map which
displays a spatial distribution of the signals the entire sensor
field, or a selected portion thereof. The user is able to alter the
color scale to enhance intelligibility, and to zoom and pan over
the map; (ii) Query the history of any sensor via a double click,
which brings up the history of the sensor values over a user
specified time interval, and (iii) Multiple correlation of any
collection of sensor histories so as to detect possible common
mechanisms for clinical disorder.
[0038] Referring now to FIG. 2, the Smart Mattress system of FIG. 1
is shown in greater detail. The Smart Mattress 202 includes one or
more sensors 220, which produce measurement data used in
determining a patient's physiological state, such as patient
vitals. Preferably, the sensors 220 include a sensor grid 772 (FIG.
7), and one or more patient-mounted sensors such as an ECG sensor
system, EEG, an oximeter, pressure sensors, blood pressure
device(s), piezoelectric elements, thermometers, insulin detectors,
blood-oxygen sensor, impedance for plethysmography, carotid pulse
wave detector(s), and/or any other physiological sensor capable of
being interfaced with the breakout unit 700. In a particularly
preferred embodiment, the sensor grid senses pressure and/or
temperature and/or liquids, while an oximeter and/or ECG and/or
blood pressure sensors are patient-mounted but coupled to the
breakout unit 700 wirelessly or through cables plugged into the
breakout unit connector panel (to be discussed below).
[0039] The processor 218 uses measurement data received from the
one or more physiological sensors 220 and/or information stored to
the internal memory (e.g., DSU) 222 to produce dynamic patient
data. Dynamic patient data may include information such as a
patient's physiological data, doctors' comments, and/or information
useful to treatment of a patient, such as patient vitals
(including, but not limited to, body temperature, Systolic and
Diastolic blood pressure, ECG, SIDS, breathing rate, weight, oxygen
saturation, acoustic pickup (e.g., detecting snoring--which may
present a medical condition), and liquid-sensor). The DSU also
stores patient identification data (or demographic data) such as
name, height, weight, sex, date of birth, race, religion, blood
type, treatment status and disposition, current patient history,
provider name, date and time of last update, patient position, and
triage information. The DSU also stores mattress data such as
manufacturer, identification, location, maintenance, repair, and
cleaning information. The stored data may be time-stamped and
stored to the DSU 222 and/or wirelessly transmitted using
transmitter 216. The Smart Mattress 202 may also include a
microphone 230 and speaker 228 allowing for verbal communication
between the Smart Mattress 202 user and portable device 206,
monitoring station 110, and/or computer server 212. Preferably, the
processor uses the dynamic patient data and/or the patient
demographic data to generate one or more patient medical reports
and/or records, which are stored in the DSU 222 and/or transmitted
to the portable device 206, monitoring station 110, and/or computer
server 212. The breakout unit is also capable of receiving data
(wired and/or wireless). For example, modified patient medical
records and/or mattress/bed data can be uploaded into DSU 222 for
bedside access. Also, the portable device 206, the monitoring
station 110, and/or the computer server 212 may transmit any
command to the breakout unit, such a begin-scan command, an
upload-medical-record command, a change-scan-timing command, a
validate-sensor(s) command, and calibrate-sensor(s) command
etc.
[0040] The DSU 222 is capable of collecting and disseminating
patient information from initial patient assessment through
disposition (to provide an electronic patient medical record),
including triage, treatment and transport of patients for daily and
mass casualty operations. To better prepare for disasters, major
hurricanes, earthquakes, terrorist acts, mass casualty events and
disease epidemics, the DSU 222 may link remote health care
providers with on-scene responders and track patients from first
assessment through triage, treatment, and transport. The DSU 222
may also store information regarding any medications and dosages
(including intravenous fluids, morphine, and other medications),
treatment status, disposition of treatment and physician
comments/instructions/prescriptions, and include a time stamp of
any update.
[0041] In a preferred embodiment, the Smart Mattress 202 uses
Bluetooth.RTM. Technology to communicate patient and/or mattress
data to/from a communication network 204 and/or to a monitoring
station (e.g., a nurses' station). The communication network 204
includes a server 212, a wireless transmitter 214, and storage
memory 210. The storage memory 210 may replicate the structure and
functions of the DSU 222, and may store further data useful to
medical care providers, insurers, governmental entities, etc. The
communication network 204 is capable of receiving patient data from
the Smart Mattress 202 via Bluetooth.RTM. technology or other
wireless means (e.g., WiFi). The communication network 204 stores
the received patient data in the storage memory 210 and/or
wirelessly communicates it to a portable device 206, e.g., at a
nurses' station or on a Doctor's PDA. The communication network 204
may use Bluetooth.RTM. technology to communicate with the portable
device 206; however, depending on the required range, it may also
use another method of wireless communication such as radio
frequency communication, microwave communication, or infrared
("IR") short-range communication. The portable device 206 may be
carried by a caregiver, nurse, and/or Doctor 208, or other
personnel interested in the health of a patient. Conversely, any of
the above data may be transmitted into the breakout unit from any
of the portable unit(s)/nurse's station(s)/local server(s)/remote
server(s). For example, when a new patient is transferred into the
mattress/bed, the breakout unit can be commanded to erase the
previous patient's medical record, and the new patient's medical
record can be uploaded into the mattress.
[0042] In another embodiment, the communication network 204 is
further capable of using a mobile network 224 (e.g. a cellular
network, GSM, or other public communication channel) to communicate
patient and/or mattress data to portable devices 206 capable of
connecting to mobile network 224 including, but not limited to, a
cell phone, smart phone or other hand held portable device. In
certain embodiments, various existing portable device's 206 are
modified merely by software and/or minor hardware changes to carry
out patient monitoring/alarming. This capability is particularly
useful in circumstances, for example, where the primary physician,
or care giver, is on holiday or when the monitored patient is in
home care. For example, a doctor attending a conference is
Switzerland is able to quickly check the status of his US patients
using only his smart phone and without interrupting the patient.
Further, if any vital of a patient deviates from a predetermined
range, the doctor, emergency medical personnel, and/or any medical
staff may be instantly and automatically notified by an alarm,
e-mail, call, page, message, or the like alert. This communication
capability is also useful for validation and calibration of the
sensors, which will be helpful for FDA approval and other
quality/maintenance reporting requirements.
[0043] Similarly, patient and/or mattress data may also be pushed
to the Word Wide Web 226 allowing a care giver 208 to access the
information from any computer or PDA server by merely visiting a
website and entering their identification information along with
any other credentials useful in identifying the user. For security
purposes, the website may further require the use of an
authentication mechanism such as a piece of hardware (e.g. a token
or USB) or software (e.g. a "soft token" for a PDA or cell phone)
assigned to a computer user that generates an authentication code
or password at fixed intervals. An exemplary authentication
mechanism is available from RSA, the security division of EMC, at
http://www.rsa.com.
[0044] Referring now to FIG. 3, another embodiment of the present
invention is shown. As in the prior embodiment, the Smart Mattress
302 includes one or more sensors 320, which produce physiological
measurement data used in determining a patient's physiological
state, like those discussed above. The processor 318 uses
measurement data received from the one or more sensors 320 and
information is stored to the DSU 322 to produce patient data. As
distinct from the prior embodiment, in this embodiment, the Smart
Mattress 302 may use Bluetooth.RTM. Technology to communicate
patient and/or mattress data directly to a portable device 306.
Preferably, the portable device 306 may be carried by a caregiver
308 or other personnel interested in the health of a patient.
Alternatively, the Smart Mattress 302 may be capable of pushing the
dynamic patient data to the World Wide Web 326 or to a mobile
network 324 which may transmit the dynamic patient data to one or
more portable devices 306.
[0045] To eliminate the need for multiple devices, a single
portable device 306 may include all of the hardware and/or software
necessary to make the portable device capable of communicating with
the Smart Mattress 302 in any of the ways describes above.
[0046] FIG. 4 is an exemplary screen shot of the display panel of
the portable devices disclosed in FIGS. 1, 2 and 3. In FIG. 4, the
portable device 400 is capable of displaying a number of patient
vitals as well as other patient and/or mattress data either
simultaneously or within a plurality of windows. The portable
device 400 contains patient details 412 such as a patient's name,
time of arrival 414, social security number, hospital
identification number, medications, allergies, prescriptions, etc.
The portable device is also capable of displaying reassessment
vitals 406 (e.g., physiological data) which are measured via a
Smart Mattress. In addition to reassessment vitals, the time of
reassessment 404 and details of the reassessment 402 may be
displayed. These fields would include information regarding any
changes to the patient's status and some background on the
patient's health, as well as the time of the most recent
reassessment and of prior assessments. The portable device 400 also
stores information regarding the health care provider and/or
physician responsible or on call for the patient. A provider for
reassessment 408 is displayed along with the time of the most
recent or next reassessment 420. Other useful fields are the
clinical comments and diagnosis field 416 and prescriptions 418 or
current drug/IV rations. The portable device 400 may even provide
miscellaneous information such as a patient's religious preference
424, current disposition 410, and the duration of a patient's
disposition 422. Naturally, the portable device would include an
interactive means (e.g., a keyboard, touch screen, and/or voice
command) to allow a physician or caregiver to input new patient
data or comments or to change existing patient data or comments.
Any additions or changes to a patient's profile would be
communicated to the Smart Mattress DSU, as well as to any
intermediate computer servers, so that data stored on the mattress,
the portable device and the computer server is constantly
synchronized.
[0047] In certain embodiments, the portable device 400 may also
provide voice communication functionality which allows for real
time communication between the patient and the care giver. This may
be accomplished using over-the-air radio, short wave, cellular,
GSM, internet or other communication methods known in the art,
to/from a microphone/speaker apparatus mounted on the mattress
and/or the patient. If the patient or caregiver is unavailable, the
portable device 400 and/or Smart Mattress may also be capable of
recording voice messages, communicating recorded messages, and/or
storing/accessing recorded messages from a network (e.g.
voicemail).
[0048] Referring now to FIG. 5, the portable device 500, processor
510, DSU 512 and wireless transmitter 516 are shown. As with the
Smart Mattress, the portable device 500 includes a processor 510
and may use Bluetooth.RTM. technology or other wireless means to
communicate with other devices, including a Smart Mattress,
computer network, or other devices. Data may be modified or
inserted using a manual user interface 508, such as a keyboard,
touch screen, and/or voice command. Patient and/or mattress data,
software, and any other data or programs may be stored in the DSU
512. The DSU 512 may be removable or internal. In certain
embodiments, the DSU 512 may include both an internal memory and
removable memory (e.g., flash memory) to allow for easy data
transfer and backup. The portable device 500 may also include a
wired communication port 514 such as USB or FireWire. The wired
communication port 514 allows for connection to and communication
with other devices such as a computer. The portable device 500 also
includes one or more audio-visual components, such as a screen 504
(e.g., LCD display), one or more speakers 502 and, in certain
embodiments, a portable printer 506. The portable printer 506 could
be used to print patient medical reports or medical prescriptions
on the spot, eliminating the risk of an error in reading an
illegible doctor's note or prescription. The printer may integrated
into the portable device or connected by wired or wireless means
(e.g. Bluetooth).
[0049] FIG. 8 shows an example of a patient display 800 presented
on the display 504 of the mobile unit 500. For example, where the
Smart Mattress includes a grid of sensors detecting pressure (to be
described below), the pressure output of numbered sensors 21-16
through 21-21 may be shown in graph form 802. A color-coded
representation of the patient's body may be displayed at 804, with
the darker areas showing areas of lighter pressure. This will be
instrumental in displaying, diagnosing, and treating decubitus
ulcers.
[0050] Referring now to FIG. 6, an example diagram of an uncovered
Smart Mattress 602 is shown. A Smart Mattress 602 should be capable
of providing all of the disclosed monitoring features while still
providing the comfort and safety features usually associated with
traditional and/or hospital mattresses. The mattress 602 may be
constructed from a number of materials (e.g. traditional inner
spring, foam, air, gel, water, etc.). The mattress 602 may also
have a firmer (and/or higher) perimeter 604 to help keep the
patient centered on the mattress and in substantially constant
contact with one or more sensor pads 606. Additionally, the
underside of the mattress 602 may have fasteners, such as magnets,
and/or hooks and loops (e.g. VELCRO), to help keep bed linens in
place and to keep the mattress 602 from sliding or shifting.
[0051] The mattress top surface may include one or more sensor pads
606, or sensor areas, capable of detecting and/or measuring a
patient's physiological characteristics from under a sheet and
without sacrificing comfort. A single sensor pad 606 is depicted;
however, a number of sensor pads 606 in various shapes, sizes, and
sensitivity levels may be used. The one or more sensor pads 606 may
be completely integrated with the mattress 604 or detachable to
allow easy replacement if damaged. In the preferred embodiment, the
sensor pad 606 is disposed within the mattress, under the top
mattress surface or top upholstery layer (e.g., the comfort layer,
typically comprising an insulator, a middle upholstery layer, a
quilt layer, and the ticking), although the sensor pad(s) may be
installed in between any of the top upholstery layer. Preferably,
the sensor pad is installed in a protective envelope (to be
discussed below). The sensor pad(s) 606 may be hard-wired to the
breakout unit 700 or may utilize a detachable plug or clip. In
either variation, it would be advantageous to connect each sensor
pad 606 to the breakout unit 700 such that any sensor cables are
not visible. The cable(s) may sit in one or more trenches or
grooves in the mattress surface. Alternatively, the mattress sensor
pad(s) 606 may be installed in a traditional mattress pad, or in an
envelope 618 which may be coupled to the top surface (and perhaps
to one, two, three, or four of the side surfaces as well) of the
mattress. In any event, the material covering the sensor pad(s) 606
should be water and stain resistant, breathable, and waterproof,
such as the material now used for hospital scrubs. Some water
permeability, however, may be desired so that the sensor pad(s) 606
may detect the presence of liquids such as urine and/or blood.
[0052] When a patient lies on the Smart Mattress 602, the one or
more sensor pads 606 gather physiological characteristic data in
real time. The one or more sensor pads 606 may gather data
including, but not limited to, pressure, temperature, blood
pressure, blood-oxygen, weight, breathing rate, heart rate, sound,
liquids, etc. Weight may detected by summing (integrating) the
outputs of one or more of the pressure sensors of the sensor pad,
and then calibrating the outputs for various weights.
Alternatively, weight could be measured by placing a sensor pad
beneath the mattress and then determining the distances between the
sensor pad 606 elements and the bottom sensor pad element(s);
weight will vary as a function of such distances.
[0053] An exemplary sensor pad is the Non-Invasive Analysis of
Physiological Signals (NAPS) system that was designed and developed
at the Medical Automation Research Center at the University of
Virginia. The NAPS system pad uses ballistocardiography (BCG) to
detect minute forces generated during cardiac contraction and
relaxation, and can also detect body movement from respiratory
effort and postural changes. The system disclosed in U.S. Patent
Publication No. 2005/0124864 to Mack, which is hereby incorporated
by reference in its entirety herein, discloses a system for
non-invasively detecting, monitoring, and analyzing physiological
characteristics using a mattress pad. The system relies on a highly
sensitive pressure transducer pneumatically connected to a
compliant force-coupling pad installed on a mattress.
[0054] In certain embodiments, all of a patient's physiological
characteristics might not be easily monitored using a sensor pad
606. In this situation, one or more wireless sensors 610 may be
equipped with Bluetooth technology allowing the wireless sensors
610 to communicate directly with the Smart Mattress 602. In
addition to (or alternatively) wired sensors 612 may be used. Such
wireless and/or wired sensors may include ECG, oximeter,
thermometer, heart rate, blood pressure, and/or breathing rate
sensors, etc. In the case where wired sensors are used, the
breakout unit 700 may have a connector panel 620, which may include
one or more terminals 608 with a number of wired connectors 614
that allow for the connection of one or more traditional wired
sensors 612. Depending on the application, each terminal 608 may
contain a single connector type or, to enhance flexibility, a
variety of connector types such as RS-232, Ethernet, US-B, RCA,
co-axial, etc. The terminals 608 may be located on one or more of
the sides of the mattress 604, however, for convenience, it may be
advantageous to install the terminals 608 on a mattress 604 side
and closer to the head end and adjacent to or affixed to the
breakout unit 700.
[0055] FIG. 9 is a schematic perspective view showing an
alternative embodiment of the Smart Mattress, with the sensor
pad(s) installed in an envelope or enclosure 904 affixed to the top
surface of a mattress. This embodiment is useful, for example, in
retro-fitting a current mattress with the Smart Mattress
technology. As one example, the envelope 904 may comprise a fabric
with water-shedding properties and defibrillation protection. For
example, Mertex-Plus fabric is a 3-layer impervious, reusable,
micro fiber possessing excellent repellent and/or absorbent
properties, suitable for use in potentially contagious procedures
where 100% protection is required. It contains carbon yarn which
provides defibrillation protection to the sensor pad sensors and
wiring. In FIG. 9, a standard foam mattress 902 has the sensor pad
enclosure 904 affixed to the top surface thereof by, e.g., straps,
Velcro, zippers, magnets, etc. One, two, three, or four sides of
the sensor pad enclosure 904 preferably has/have a plastic zipper
closure 906 for access to the inside of the enclosure. The sensor
pad(s) 918 can be inserted into the enclosure 904 through one or
more of the zipper openings. Preferably, the sensor pad enclosure
904 is designed for patient comfort. The sensor pad enclosure 904
should also provide a uniform pressure transfer function, and not
interfere with the accuracy of the sensor readings. The sensor pad
enclosure 904 should be easily removable for cleaning, sanitation,
and repair, and also may be impervious or semi-impervious to body
fluids. The entire enclosure, both top and bottom, should not admit
(under long term usage) transmission of fluids such as blood and
urine to the electronic components of the pad, unless liquids are
to be detected.
[0056] FIG. 10 is a schematic of a preferred sensor pad showing the
sensor pad wiring arrangement (only a portion of the wiring is
shown, for clarity). A sensor pad 1018 includes a plurality of
sensors 1020 coupled to a sensor mesh comprising a plurality of
column conductors 1022 and a plurality of row conductors 1024. A
first prototype of the preferred sensor pad was constructed having
256 sensor elements at a 1 cm separation. A full-scale pad may
comprise, e.g., 6144 sensor elements coupled by 64 column
conductors and 96 row conductors. Preferably, the sensor pad
substrates are polyethylene, although printable microfibers or
other textiles and/or fabrics could be used. The conductors are a
first type of conductive ink printed on the substrates, while the
sensor elements comprise a second type of conductive ink, one
sensitive to pressure and/or temperature and/or liquid. For
example, Creative Materials, Inc. of Boston, Mass. produces
acceptable inks and adhesives for this application. In particular,
the conductors may be screen-printed silver compounds, while the
sensors may be screen-printed carbon compounds. Preferably, the end
of each conductor terminates in a circular through-hole to simplify
coupling to the connector (to be discussed below). It has been
found that the flexibility of the pad can be enhanced, and the
electrical conduction greatly improved by punching one or more
square or circular holes 1026 through the pad in-between the
sensors and the conductors, as shown. Without the holes 1026, when
a person lies on the pad, the folds and wrinkles therein may cause
varying resistance in the conductors, leading to poor signal
stabilization and poor signal-to-noise ratio. The holes allow the
pad to remain relatively flat, improving signal detection,
stability, and accuracy in the conductors. A liquid sensor may
comprise one or more conductors without coupled sensor elements.
The presence of liquid is sensed by electric and/or magnetic field
changes surrounding the conductor(s).
[0057] Thus, the pad 1018 comprises an array of sensors embedded in
a flexible material pad which covers a mattress and which reports
the spatial distribution of pressures and/or temperatures generated
by a person lying on the pad. The pad is preferably sampled at a
user-selected frequency and the sensor values are assembled at the
breakout unit processor attached to the pad. In turn, the breakout
unit transmits by wire and/or wirelessly to the MDU 724, which may
be local or at a remote location. At the MDU 724, the sensor values
are preferably plotted in real time as a color coded body map 804
(FIG. 8). This map may be used to compute and track important
vitals such as respiration and the formation of decubitus
ulcers.
[0058] FIG. 11 is a partial schematic showing some of the pad
sensors, some of the pad conductors, and how they are coupled to
the breakout unit. The sensor pad 1118 has sensors 1120 coupled to
the connector 1130 through column conductors 1122 and row
conductors 1120. Digital switches 1032 in the breakout unit 700 can
be opened and closed under processor-control in order to scan the
signals coming from the sensors. The sensor pad can be interfaced
with the processor 218 through any known connector terminal, or
wirelessly. The breakout unit 700 is preferably powered by
rechargeable, replaceable batteries. The time to fully charge is
preferably less than 6 hours. The battery life, under normal
conditions is preferably greater than 1000 hours. As an example of
a wired connector for a smaller pad covering half the mattress, the
connector preferably accommodates at least 32 rows by 32 columns
(1024 sensels per pad). The breakout unit 700 is preferably able to
acquire 10 pad frames per second @2 Bytes per sensel; thus
providing for a sampling rate of approximately 20 Kbyte/sec. The
breakout unit 700 preferably outputs a serial USB data stream to
the MDU and/or remote unit. Further, the breakout unit 700 accepts
commands, encoded as the output stream, from the MDU and/or remote
unit. The breakout unit 700 preferably supports both Bluetooth
communication in the case that the MDU is situated locally, and
WiFi in the case that the MDU is to be found at a remote IP
address. In the case where the MDU is remote, communication over
the Internet is preferably be expedited via a third party
server.
[0059] FIGS. 12a, 12b, and 12c are notional schematic drawings
showing the assembly of the sensor pad. In FIG. 12a, the column
layer 1250 comprises a series of parallel column conductors 1222
embedded and/or printed and/or adhered to one side of a substrate,
such as a 5 mil sheet of polyethylene plastic. This layer is
proximal the mattress. The sensor layer 1252 comprises a series of
pressure and/or temperature and/or liquid sensing elements 1222;
preferably, those whose electrical resistance varies as a function
of pressure and/or temperature and/or liquid. For example, when
sensing pressure, each sensing element has an electrical resistance
density which is a calibrated nonlinear function of pressure across
the layer. The sensing elements 1222 are embedded as a series of
dots, squares, triangles, and/or other shapes on a polyethylene
sheet. The row layer 1254 comprises a series of row conductors 1224
embedded on a polyethylene sheet. As shown in FIGS. 12b and 12c,
the sensor layer 1252 is placed atop the column layer, and the row
layer is placed atop the sensor layer 1252. The three layers are
fixed together by heat treatment and/or adhesives. If desired,
additional sensor layers and conductive layers can be sandwiched
together such that each sensor layer detects one parameter. For
example, a first sensor layer may detect pressure, a second sensor
layer may detect temperature, and a third sensor layer may detect
liquids. Of course, as many sensor layers may be added as desired,
but it would be preferable to combine as many sensing functions
into as few layer as possible. Preferably, the top and bottom
layers are made from a flexible, nonconductive material, such as
low durometer neoprene rubber. Optionally an additional layer may
be added on top to suit the comfort of the patient. Each printed
conductor connects to an insulated conductor 1272, 1274, which runs
along an edge or off the edge of the pad. These conductors are
terminated by means of a digital switch located on the PCB
connector 1130 as illustrated in FIG. 11. For example, to measure
the pressure at the intersection of a given row and column, the
column switch is closed and a voltage applied to the column through
the connector. The corresponding row switch is closed and the
output voltage measured by the connector. The scanned voltage
measurements are synthesized into a whole-body matrix, for example,
the color graph of FIG. 8.
[0060] In a particularly preferred embodiment,
non-pressure-sensitive, conductive-ink row conductors are first
printed on a 5 mil polyethylene sheet. An adhesive is then applied
at every spot where a pressure-sensitive conductive ink sensor is
to be applied. One half of the pressure-sensitive conductive ink
which comprises each sensor is then applied over the adhesive. This
process is then mirrored for the column conductors. The two sheets
are then pressed together and heat treated to seal the pad.
[0061] An alternative embodiment features the sensing elements 1222
detecting movement of the patient through detection of shear forces
on each sensor element 1222. Specifically, in the case of pressure,
each sensor element detects compaction of the conductive ink.
Conductive inks are now available which detect stretching of the
ink by a change of resistance in accordance with stretching. With
such inks, shear stresses can be measured and calibrated in
accordance with patient movement. This will help in detection and
treatment of decubitus ulcers. As another means of detecting
movement, a body-scan of pressure sensors may be stored in memory,
and then compared with future scans taken at predetermined
intervals. In a further alternative, pressure-sensing and
shear-sensing sensors are interweaved on the same sensor pad; even
sensors detect pressure, while odd sensors detect shear. This
embodiment may be expanded to interweaving sensors, such as
pressure, temperature, liquid, shear, etc., in any combination and
in any pattern.
[0062] Preferably, the leakage current to which a patient is
exposed does not exceed 5 mA in the case of a sensor pad with the
maximum number of rows and columns. Defibrillation protection is
provided by the connector being designed and tested such that it
does not fail when a 5 KV pulse is applied between any input leads
for a period of 10 seconds. This pulse represents the maximum shock
delivered when a patient is defibrillated while on the pad. The
Connector is preferably isolated from the patient, and all RF
communication is preferably effected with commercially available
transceivers which have met the FCC requirements for EMI.
Defibrillation protection is provided by the Mertex-plus envelope
and/or by electrical isolators installed on the pad or in the
breakout unit.
[0063] FIG. 13 is a notional cross-sectional view of the pad 1318,
showing sensing elements 1320, column (or row) conductor 1322, and
row (or column) conductors 1324. The bottom substrate is 1336 and
the top substrate is 1338. These substrates are supportive,
non-conducting material such as polyethylene, rubber, fabric,
and/or neoprene. The conductive traces may be woven into the
supportive material, and extend preferably beyond the material on
one side for connection. This could be accomplished by the
bi-laminar row-column construction. Alternatively, as described
above, the conductive trace could be printed with conductive ink on
the supportive non-conducting material. The column to which the
input voltage is supplied is selected by closing the I-th column
switch in the electronic connector, while the row through which the
output voltage flows is selected by closing the J-th Row switch in
the connector, under control for the breakout unit and/or MDU. The
circuit is preferably a simple series of resistors from which it
follows that
V.sub.out=V.sub.in-I[R.sub.col I+R.sub.row J+.rho.(p.sub.ij)]
(1)
and therefore the pressure at Column I, Row J is calculated as
p.sub.ij=.rho..sup.-1(V.sub.out-V.sub.in+I[R.sub.col I+R.sub.row
J]). (2)
2. Functions
[0064] The breakout unit 700 described above includes the mattress
sensor grid, the DSU for storing (i) patient vitals (including, but
not limited to, body temperature, (perhaps Systolic and Diastolic
blood pressure), ECG, SIDS, breathing rate, weight, oxygen
saturation, acoustic, and liquid-presence), (ii) other patient
information (including, but not limited to, name, height, weight,
sex, date of birth, race, religion, blood type, treatment status
and disposition, current patient history, provider name, date and
time of last update, patient position, and triage information), and
(iii) mattress information (including, but not limited to,
manufacturer, identification, location, maintenance, repair, and
cleaning information) The breakout unit also includes a processor
218 for handling, processing and/or time-stamping any updates to a
DSU. The sensors may be embedded in the mattress and/or directly
coupled to the patient. When the sensor is coupled to a patient,
the Smart Mattress may wirelessly communicate information with the
sensor using short-range wireless communication, e.g., Bluetooth
technology. Alternatively, the Smart Mattress may include ports
where additional wired sensors may be connected by the user. As
another alternative, the breakout unit itself may comprise the MDU,
with a display, keyboard, and/or touch-screen GUI.
[0065] The Smart Mattress includes an on-board power source, such
as a rechargeable battery, to increase the portability of a Smart
Mattress. The rechargeable battery may be recharged using the
standard AC wall current, or the battery may be removed and charged
using a dock or charging station. Alternatively, a Smart Mattress
may be capable of receiving power directly from an auxiliary power
source (e.g., wall socket, solar panel or other generator).
[0066] The DSU is capable of collecting and disseminating patient
information from initial patient assessment through disposition (to
provide an electronic medical record), including triage, treatment
and transport of patients for daily and mass casualty operations.
To better prepare for disasters, major hurricanes, earthquakes,
terrorist acts, mass casualty events and disease epidemics, the DSU
may link health providers with on-scene responders and track
patients from first assessment through triage, treatment and
transport. The DSU may also store information regarding any
medications and dosages (including intravenous fluids, morphine and
other medications), treatment status, disposition of treatment and
physician and include a time stamp of the last update.
[0067] Sensors or other monitoring devices should be in constant
proximate contact with a patient, allowing for continuous updates
to the data in a mattress's DSU. The Smart Mattress may also be
capable of simultaneously updating a medical facility's information
system and a provider's or first responder's portable device with a
patient's vital sign information. Simultaneously updating a medical
facility's information provides a backup in the event of data loss
in the Smart Mattress.
[0068] Updates regarding a patient's information may be
communicated using wireless technology between a medical facility,
health care provider or portable device and the DSU in the Smart
Mattress. Similarly, if patient information (e.g., vitals or health
condition) deviates from an established range or value, that
information may also be wirelessly communicated to a health care
provider either directly from a Smart Mattress or via a computer
network.
[0069] Two of the more popular types of wireless technology
standards available are Bluetooth.RTM. and the Institute of
Electrical and Electronic Engineering's (IEEE) 802.11 standards
("Wi-Fi"). Bluetooth.RTM. is an open specification delivering
short-range radio communication between electrical devices that are
equipped with Bluetooth.RTM. chips. When two Bluetooth.RTM.-enabled
devices are within communication range (presently about 10 meters),
they send each other a unique ID to identify one another. This ID
is used to determine the type of information to be shared and the
level of functionality that could occur between the two devices.
However, Bluetooth.RTM. is not designed for long-distance
communication but rather as a means for providing connections
between mobile computing devices or between a mobile computer
device and a hub. To increase operating range, an potential
solution would be to couple Bluetooth.RTM. technology with Wi-Fi,
which has a larger operating range of up to 300 meters. Wi-Fi is an
extension of the wired Ethernet and uses the same principles as its
wired counterpart, thus providing its users with high-speed,
reliable connections to a network. Alternatively, a Bluetooth.RTM.
range extender may be integrated into the system to enhance the
communication range and to eliminate the need for Wi-Fi.
[0070] A medical provider may utilize the portable device to access
and update patient information stored in a Smart Mattress. Using
the portable device allows for more flexibility when monitoring a
patient or during emergency evacuations by allowing the health care
provider to monitor from a distance or to receive automatic alerts
when a patient's condition changes. Since patient vitals and
demographic information are stored in the Smart Mattress's DSU,
there is no need to input this information when updating a
patient's status and disposition during relocation or evacuation.
The Smart Mattress DSU also eliminates the need for a paper-based
system both during emergency evacuations and in general patient
monitoring. Medical staff or health care providers are able to
conduct a reassessment of a patient's condition and upload those
comments to the DSU in a mattress using a portable device. The time
of a reassessment may also be automatically time-stamped in order
to track a patient's condition. A provider will additionally be
able to note what time a patient arrived at a certain location.
[0071] The portable device allows a care provider to review patient
information from a distant location, make a diagnosis and upload
that information to a DSU in a Smart Mattress via wireless or wired
communication. Additionally, if a health care provider feels a
patient needs immediate medical care, the provider may order
certain actions that would be sent to on-site personnel, a medical
unit or an evacuation site. Provider-directed actions could also be
sent directly to a staff member's portable device. Ideally, the
hospital or evacuation site would have a monitoring station that is
capable of communicating information with a Smart Mattress, similar
to an intensive care unit's nursing station which monitors patient
information, enabling quick medical decisions.
[0072] The Smart Mattress is ideal for use as an emergency
evacuation mattress for bed-ridden patients. This is due in part to
a Smart Mattress being self-contained, capable of monitoring vital
statistics of a patient in real time, analyzing data using an
embedded processor, storing patient identification and information,
producing an electronic medical report, and communicating any data
to the caregiver or computer server using wireless technology.
Integrating Smart Mattress functionality (e.g., the features of a
Smart Mattress) with an evacuation mattress, such as the Evacusled,
is a life-saving combination.
[0073] An Evacusled, or evacuation mattress, is disclosed in U.S.
Patent Publication No. 2008/0301876 to Christopher Kenalty, and is
hereby incorporated by reference in its entirety herein. Evacusled
teaches an emergency evacuation mattress for bed-ridden patients
that is capable of operation by a single caregiver, provides a warm
and secure cocoon for a patient, allows easy transport over any
type of surface, provides proper support for all of a patient's
body and bedding, and allows a patient to feel a high degree of
comfort in what is otherwise a very stressful situation. The
Evacusled would be an ideal candidate for integration with the
Smart Mattress and/or Smart Mattress functionality.
[0074] Several other advantageous evacuation devices and techniques
are also disclosed in U.S. Pat. No. 5,249,321 to Jorg Graf and U.S.
patent Ser. No. 12/700,027, filed Feb. 4, 2010, to Christopher
Kenalty, which are incorporated by reference herein.
[0075] The Smart Mattress is also ideal for detecting symptoms of
SIDS. The sensor pad array of pressure-sensitive elements is
capable of detecting both respiration (breathing rate) and heart
rate. Signal processing will filter, normalize, and amplify the
detected pressure signals to determine the pressure variations
caused by breathing and heart-beats. One or both of these signals
can be compared to predetermined thresholds (which may be set or
modified by the user or medical staff) to detect abnormal breathing
or cardiac arrhythmia. For example, if regular breathing stops for
7 seconds, and/or a regular heart-beat stops for 5 seconds, an
alarm signal will be generated. The alarm signal can be a local
audible signal to stimulate the patient, and/or transmitted
wirelessly to a parent or care-giver.
[0076] Another area of concern during patient evacuation is
accurate tracking of a patient and mattress. This may be solved by
utilizing Radio-Frequency Identification (or "RFID") tags and/or
GPS transceivers embedded inside the Smart Mattress, enabling
real-time location and movement information which can be sent to
remote monitoring equipment or medical staff during emergency
evacuation--ensuring a facility has not left anyone behind.
[0077] The Smart Mattress, either alone or in combination with the
Evacusled, should be capable of providing all of these novel
features while still providing the comfort and safety features
usually associated with traditional and hospital mattresses. For
example, the Smart Mattress should be designed to reduce the
potential for pressure ulcers. This can be accomplished using
embedded sensors in the mattress that would map pressure points and
alert medical staff when an area exceeds the established threshold.
All pressure point information may also be stored in an embedded
DSU.
[0078] The Smart Mattress may include a cover (e.g., nylon, vinyl,
plastic) to help reduce the likelihood of fluid penetration and
prevent damage to electronic devices stored in the mattress. Having
a firmer perimeter foam built into a Smart Mattress could help keep
a patient centered on the mattress at all times and therefore
reduce the risk of rolling out of bed. The Smart Mattress and
Evacusled components will be radiolucent to allow x-rays to pass
through them. A critical care bed should have a radiolucent
platform attached to the bed deck and a radiolucent mattress, or
Smart Mattress, to allow the use of fluoroscopy at the bedside. To
allow for bedside x-ray use, the Smart Mattress and Evaculsed combo
should both be radiolucent, a feature that, due to its versatility
and ease of use, will be well-received in the critical care bed
market.
[0079] A potential alternative to creating a 100% radiolucent Smart
Mattress and Evacusled combo is to create an x-ray cassette sleeve
in the side of the mattress. The side opening allows for easy
insertion of an x-ray cassette. The sleeve could be located under
the top of the mattress (e.g., approximately 1 inch deep) so as not
to be in direct contact with the patient. This method would
increase patient and caregiver safety and reduce the chances of
injury associated with portable x-ray procedures.
[0080] During daily use, the external skin of the Smart Mattress
may become dirty, damaged or torn, especially when the Smart
Mattress is used during an evacuation procedure, where the
underside (e.g., adjacent to where wheels may be located on a
traditional Evacusled) may easily become damaged due to abrasions
from transport. Due to the costs of mattresses, including the Smart
Mattress, it would be advantageous to provide a replacement skin
that a hospital could purchase for the Smart Mattress or Smart
Mattress/Evacusled combo rather than having to buy an entirely new
system.
[0081] The top skin and bottom skin panels may be zipped together
and secured with a flap to form a continuous skin. In another
embodiment, the skin may also include an intermediate side-wall
skin between the top and bottom skin panels. The skin material
should meet infection control measures and may also contain
microclimate features. The replacement skins would retail for just
a fraction of the cost of the Smart Mattress, therefore enhancing
the life of the Smart Mattress and/or Evacusled.
[0082] The Smart Mattress and/or Evacusled should meet the
demanding infection control measures which are essential in medical
facilities. A solution to maintain an anti-fugal and anti-bacterial
mattress surface would be to coat the mattress system with spray-on
liquid glass. Spray-on liquid glass is transparent, non-toxic, and
can protect virtually any surface against almost any damage from
hazards such as water, UV radiation, dirt, heat, and bacterial
infections. Liquid glass coating is also flexible and breathable,
which makes it suitable for use on hospital mattresses.
[0083] Liquid glass spray (also referred to as "SiO2 ultra-thin
layering") comprises almost pure silicon dioxide (silica, the
normal compound in glass) extracted from quartz sand. Water or
ethanol is added, depending on the type of surface to be coated.
There are no additives, and the nano-scale glass coating bonds to
the surface because of the quantum forces involved. Liquid glass
has a long-lasting antibacterial effect because microbes landing on
the surface cannot divide or replicate easily.
[0084] Liquid glass spray produces a water-resistant coating only
around 100 nanometers (15-30 molecules) thick. On this nano-scale
the glass is highly flexible and breathable. Liquid glass coating
is environmentally harmless and non-toxic, and easy to clean using
only water or a simple wipe with a damp cloth. It repels bacteria,
water and dirt, and resists heat, UV light and even acids. Food
processing companies in Germany have already carried out trials of
the spray, and found sterile surfaces that usually needed to be
cleaned with strong bleach to keep them sterile needed only a hot
water rinse if they were coated with liquid glass. The levels of
sterility were higher for the glass-coated surfaces, and the
surfaces remained sterile for months. A year-long trial of the
spray in a Lancashire hospital also produced very promising results
for a range of applications including coatings for equipment,
medical implants, catheters, sutures and bandages.
[0085] Since many patients spend a majority of their hospital stays
on mattresses, and, depending on their conditions, may spend their
entire lives confined to their beds, the Smart Mattress and
Evacusled must combine the best practices of therapeutic mattress
design.
[0086] Depending on the patient's need, there may be various Smart
Mattress models. A standard Smart Mattress model may include a form
mattress and Evacusled absent additional therapeutic features. A
medical bed with air would integrate an air surface mattress to
prevent pressure ulcers and may contain multiple independent zones
of continuous low pressure to reduce the peak pressures that cause
and aggravate skin ulcers. Yet another example may be a critical
care design to be used in intensive care wards. A critical care
design would be radiolucent or contain the x-ray cassette sleeve
stated above. Additionally, a critical care mattress may have the
most advanced therapeutic feather currently available in the
marketplace (e.g., pressure redistribution surface, microclimate
mattress surface to remove heat and moisture to cool the patient
and keep the patient's skin drier, weight-based pressure sensors to
distribute patient's weight, and a patient turn-assist feature to
make it easy to change linens and conduct skin assessments on
bed-ridden, critical care patients). Naturally, various
combinations of these models may be made depending on the market's
demand.
[0087] The Smart Mattress may also use a triage tag, which is
particularly useful in emergency situations. Triage tags are tools
that are often used for first responders and medical personnel use
during a mass casualty incident. With the aid of the triage tags,
the first-arriving personnel are able to effectively and
efficiently distribute the limited resources and provide the
necessary immediate care for the victims until more help arrives.
Simple Triage and Rapid Treatment ("START") is a strategy that the
first responders and medical personnel employ to evaluate the
severity of injury of each victim as quickly as possible and tag a
victim in about 30-60 seconds. The triage tags are placed near the
head and are used to better separate the victims so that when more
help arrives, the patients are easily recognizable for the extra
help to ascertain the direst cases.
[0088] For the purpose of the Smart Mattress, Evacusled or
combination Smart Mattress Evacusled design, the triage tags will
preferably be placed on the foot-end of the mattress, so once the
mattress is deployed, the triage tag is clearly visible. The triage
tag may have a folding design allowing effective, quick and simple
triage, but more importantly the folding tag allows patients to be
re-triaged without having to replace the tag. This is in line with
States that have standardized triage tags. Presently, the U.S.
states and cities that use a standardized or Dynamic Triage Tag
include New York, Connecticut, Indiana, Illinois, North Carolina,
Nevada, Philadelphia, and Boston. The basic sections of a triage
tag include four colors of triage including: Black (Expectant)
which entails pain medication only until death; Red (Immediate)
which entails life threatening injuries; Yellow (Delayed) which
entails non-life threatening injuries; and Green (Minor) which
entails minor injuries.
[0089] The triage tag may also include a section informing medical
personnel of the patient's vital signs along with the treatment
administered, a section on the patient's demographics (i.e.,
gender, residential address, etc. and the patient's medical
history), and/or a section with a full pictorial view of the human
body where the medical personnel may indicate which parts of the
body are injured.
[0090] Although various embodiments have been described with
reference to a particular arrangement of parts, features and the
like, these are not intended to exhaust all possible arrangements
or features, and indeed many other embodiments, modifications and
variations will be ascertainable to those of skill in the art.
* * * * *
References